Suturing instrument with deflectable head

Abstract

Suturing instruments in accordance with the invention are dimensioned and configured to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, trans-vaginal, laparoscopic, or endoscopic surgical procedures. In some embodiments, the suturing instruments include a distal portion that is deflectably and/or pivotally coupled to the remainder of the instrument for improved maneuverability and functionality during surgery. In other embodiments, the suturing instruments are capable of housing multiple needle and suture assemblies and/or reloading the needle and suture assembly without removing the instrument from the surgical site.

What is claimed is: 
     
       1. A suturing instrument comprising:
 an elongate body member comprising a middle portion defining a first axis and a distal portion extending distally from the middle portion, the distal portion being deflectable in a plurality of directions with respect to the first axis, and pivotable about a second axis, the distal portion including a needle cartridge for receiving a plurality of needles; 
 a needle deployment mechanism disposed at least partially within the elongate body member, the needle deployment mechanism including a curved needle carrier that is sequentially connectable to each of the needles for moving each of the needles sequentially out of the distal portion, the curved needle carrier being disposed proximal to the needle cartridge; 
 a needle catch including a plurality of openings disposed on the distal portion of the elongate body member and configured to receive each of the needles through at least one of the plurality of the plurality of openings, and retain each of the needles; 
 a pivot wire connected to the distal portion, the pivot wire being actuated to pivot the distal portion about the second axis; 
 a plurality of tension members slidably disposed at least partially in the elongate body member and coupled to the distal portion; and 
 at least one deflection control member coupled to the plurality of tension members and disposed opposite the distal portion of the elongate body member for controlling deflection of the distal portion. 
 
     
     
       2. The suturing instrument of  claim 1  wherein a predetermined angle of deflection of the distal portion ranges from about −90° to about 90° degrees. 
     
     
       3. The suturing instrument of  claim 1  wherein the distal portion comprises a first beveled surface for contacting the middle portion, the first beveled surface defining a first angle, and wherein the middle portion comprises a second beveled surface for contacting the distal portion, the second beveled surface defining a second angle. 
     
     
       4. The suturing instrument of  claim 3  wherein the first angle substantially equals the second angle. 
     
     
       5. The suturing instrument of  claim 4  wherein a sum of the first angle and the second angle substantially equals 90 degrees. 
     
     
       6. The suturing instrument of  claim 3  wherein the elongate body member further comprises a first resilient member for biasing the distal portion towards the middle portion along a longitudinal axis of the elongate member. 
     
     
       7. The suturing instrument of  claim 3  wherein the elongate body member comprises at least one deflection control member disposed at least partially in the elongate body member and coupled to the distal portion for deflecting the distal portion at a predetermined angle relative to the middle portion by rotating the distal portion about a longitudinal axis of the elongate body member. 
     
     
       8. The suturing instrument of  claim 3  wherein the elongate body member further comprises a locking mechanism for securing the distal portion at a predetermined angle relative to the middle portion. 
     
     
       9. The suturing instrument of  claim 8  wherein the locking mechanism comprises a first plurality of teeth disposed on the first beveled surface and a second plurality of teeth disposed on the second beveled surface, the first plurality of teeth configured to mesh with the second plurality of teeth. 
     
     
       10. The suturing instrument of  claim 8  wherein the locking mechanism comprises:
 a plurality of detents defined by the first beveled surface and circumferentially disposed about the first beveled surface; and a ball disposed in the second beveled surface and dimensioned to fit at least one detent from the plurality of detents. 
 
     
     
       11. The suturing instrument of  claim 10  wherein the second beveled surface defines an aperture for receiving the ball therein. 
     
     
       12. The suturing instrument of  claim 11  further comprising a second resilient member disposed in the aperture for biasing the ball into engagement with the at least one detent from the plurality of detents. 
     
     
       13. The suturing instrument of  claim 1  wherein the elongate body member is adapted to access remote organs or tissue within a body. 
     
     
       14. The suturing instrument of  claim 1 , wherein the curved needle carrier is disposed at least partially within the distal portion of the elongate body member; the curved needle carrier being slidably movable out of the distal portion, the needle deployment mechanism further including:
 an actuator coupled to the curved needle carrier and disposed opposite the distal portion. 
 
     
     
       15. The suturing instrument of  claim 14  wherein the elongate body member further comprises a handle disposed opposite the distal portion, the handle at least partially housing the actuator. 
     
     
       16. The suturing instrument of  claim 1  wherein the needle catch defines a retention slot including at least two flexible edges. 
     
     
       17. A method for placing sutures in tissue, the method comprising:
 providing a suturing instrument comprising:
 an elongate body member comprising a middle portion defining a first axis and a distal portion extending distally from the middle portion, the distal portion being deflectable in a plurality of directions with respect to the first axis, and pivotable about a second axis, the distal portion including a needle cartridge for receiving a plurality of needles; 
 a needle deployment mechanism disposed at least partially within the elongate body member, the needle deployment mechanism including a curved needle carrier that is sequentially connectable to each of the needles for moving each of the needles sequentially out of the distal portion, the curved needle carrier being disposed proximal to the needle cartridge prior to receiving a needle of the plurality needles; 
 a needle catch including a plurality of openings disposed on the distal portion of the elongate body member and configured to receive each of the needles through at least one of the plurality of the plurality of openings, and retain each of the needles; 
 a pivot wire connected to the distal portion, the pivot wire being actuated to pivot the distal portion about the second axis; 
 a plurality of tension members slidably disposed at least partially in the elongate body member and coupled to the distal portion; and 
 at least one deflection control member coupled to the plurality of tension members and disposed opposite the distal portion of the elongate body member for controlling deflection of the distal portion; 
 
 disposing a plurality of needles within the distal portion; 
 disposing the suturing instrument in a body; 
 deflecting the distal portion of the suturing instrument in a plurality of directions with respect to the middle portion thereby positioning the distal portion proximal to the tissue; 
 pivoting the distal portion about an axis with respect to the middle portion; and 
 actuating the needle deployment mechanism thereby moving each of the needles sequentially out of the distal portion and through the tissue. 
 
     
     
       18. The method of  claim 17 , wherein the deflecting of the distal portion includes deflecting the distal portion of the suturing instrument in a first direction, a second direction, and a third direction, the first direction being different than the second direction and the third direction, the second direction being different than the third direction. 
     
     
       19. A suturing instrument comprising:
 an elongate body member comprising a middle portion and a distal portion extending distally from the middle portion, the distal portion including:
 a deflectable portion including a first beveled surface for contacting a second beveled surface of the middle portion, the deflectable portion configured to deflect in a plurality of directions relative to the middle portion by rotating the first beveled surface about a longitudinal axis of the elongate body member relative to and independently of the second beveled surface of the middle portion, 
 a pivot portion located distally of the deflectable portion; the pivot portion configured to pivot about an axis with respect to the middle portion; 
 a needle cartridge for receiving a plurality of needles; and 
 a needle deployment mechanism disposed at least partially within the elongate body member, the needle deployment mechanism including a curved needle carrier that is sequentially connectable to each of the needles for moving each of the needles sequentially out of an opening defined by the distal portion, the curved needle carrier being disposed proximal to the needle cartridge. 
 
 
     
     
       20. The suturing instrument of  claim 19 , further comprising a pivot wire connected to the distal portion, the pivot wire being actuated to pivot the distal portion about the axis. 
     
     
       21. The suturing instrument of  claim 19 , further comprising a plurality of tension members slidably disposed at least partially in the elongate body member and coupled to the distal portion. 
     
     
       22. The suturing instrument of  claim 21 , further comprising at least one deflection control member coupled to the plurality of tension members via at least one tension roller and disposed opposite the distal portion of the elongate body member for controlling the deflection of the distal portion. 
     
     
       23. The suturing instrument of  claim 19 , wherein the plurality of directions includes a first direction, a second direction, and a third direction, the first direction being different than the second direction and the third direction, the second direction being different than the third direction. 
     
     
       24. The suturing instrument of  claim 1 , wherein the plurality of directions includes a first direction, a second direction, and a third direction, the first direction being different than the second direction and the third direction, the second direction being different than the third direction. 
     
     
       25. The suturing instrument of  claim 1 , wherein the needle cartridge includes a spring-biased push plate configured to sequentially dispose each of the needles in an opening in an end of the curved needle carrier.